The overall objective of this project is to explore methods for maximizing the initiation and retention of patients in naltrexone treatment. The goal for the current project year is to assess the contribution of psychotherapeutic intervention to success in detoxification and treatment outcome with natrexone. Prospective applicants for naltrexone treatment will be randomly assigned to a therapy or no-therapy group. Both groups will be treated similarly with regard to intake, medical care, method of detoxification, and induction onto naltrexone. Patients in the therapy group will be assigned to an experienced psychotherapist for regularly scheduled sessions. The therapist will receive both individual and group supervision in an attempt to maintain homogeneity of treatment techniques. Patients in no-therapy group will receive concrete services only and not be assigned to an individual therapist. The therapy and no-therapy groups will be compared with respect to success in detoxificaion, retention in treatment, changes in psychosocial functioning, illicit drug use and other relevant parameters of treatment outcome.